Critical Policy Change Needed for Alberta’s Safe Injection Site Regulations

Opinion by Teaghan Haysom.

The lobby of a clinic.

Canada continues to battle an opioid crisis that has only become deadlier throughout the pandemic. Between April 2020 and March 2021, there were 3,691 opioid-related deaths in the country, 88% higher than the same period the year before [1]. The limited accessibility to services and support for drug users has been a main contributor to the drastic increase in deaths [1].


In Alberta, more than 900 people died from opioid use in just the first 10 months of 2020 [2]. Many drug use support services were closed through the beginning of the pandemic including counseling services and safe injection sites. As drugs like fentanyl, carfentanil, and methamphetamines are more widely available on Canadian streets, opioid-related deaths continue to reach new heights in Alberta and across Canada [3]. We need more social programs to mediate and control the ongoing effects of this epidemic.


After the Alberta government conducted a study into the effects of safe injection sites, the province announced a new set of restrictions for these clinics. Some of the regulations include seeking “good neighbor” approval, requiring safe injection sites to seek approval from neighboring businesses, and collecting personal health information from users [4]. The former will make it difficult to find areas for safe injection sites as they need to have the approval of the establishments in the near area. Due to the stigma surrounding drug users and safe injection sites, this could become challenging. Collecting the personal information of those who use the sites could be an effective way of tracking an individual's usage habits and even provide data that could assess the effectiveness of this service. However, this could also act as a barrier for users seeking support as some may be reluctant to sacrifice their privacy.


In addition to these restrictions, the province has also closed sites in Lethbridge [5], Edmonton [6] and the only site in Calgary [7]. Despite promises to open two new sites in the Calgary area, even temporary shutdowns of clinics can have a significant effect on communities. In Lethbridge, shortly after the government pulled the funding for a safe injection site, a local organization set up an unauthorized site in the city's downtown area [8]. The site was intended to be a safe and supervised place for users to consume drugs in the absence of a sanctioned safe injection clinic.


The clinic that closed in Lethbridge was the largest safe injection site in Canada and saw an average of 500 visits a day. Lethbridge has the highest per capita opioid-related deaths in Alberta [8]. Cities like Lethbridge desperately need more funding and support to try to curb the devastation of the opioid crisis. By decreasing or eliminating accessibility to the few support services that exist, the government is allowing this crisis to continue to grow.


The province suggested that these new regulations intend to focus on long-term recovery for drug users. However, restrictions act as barriers against those seeking support. Alberta Health Services reported that, in two days, emergency services responded to 55 opioid-related calls in Edmonton between May 31 and June 1st [9]. The city is seeing record numbers of opioid-related emergencies and deaths. These numbers are likely to continue to grow until increased support is provided for users.


The opioid crisis also disproportionately affects Indigenous peoples in Canada, and increasingly in Alberta. While First Nations peoples represent 6% of the province, they accounted for 22% of all opioid-related deaths within the first 6 months of 2020 [3]. First Nations peoples already face barriers in the medical system, both provincially and federally. Increased restrictions and less support for social programs will make it even more difficult for First Nations peoples to access services like safe injection sites. These barriers to support will result in a consistent increase in opioid-related deaths in these communities. The government should be investing in First Nations specific substance therapy and support services, as well as opening safe injection sites that are more accessible for those living on reserve.


With the closure and restriction of safe injection sites, more people are overdosing, and dying in the streets. While studies in Alberta have suggested that safe injection sites do not limit the amount of drug-related activity in the area, it does increase the amount of support there is for users daily, and in emergency situations [10]. Clinics have naloxone on hand which can save many lives in the area, as well as having educated medical professionals to provide care and education.


Safe injection sites are a monitored and hygienic place for users. Many also provide infection detection and treatment options, drug education programs and information about recovery resources. Most importantly, they provide a space for controlled drug use which can help prevent overdoses. Alberta’s desire to focus on a recovery-based drug prevention program is laudable, but this will not be achieved by making it more difficult for users to seek supports like safe injection sites.

Bibliography

[1] “Opioid- and Stimulant-Related Harms in Canada.” Opioid- and Stimulant-related Harms in Canada - Public Health Infobase | Public Health Agency of Canada, September 22, 2021. https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/.


[2] French, Janet. “More than 900 Albertans Died from Opioid Poisoning in First 10 Months of 2020 | CBC News.” CBCnews. CBC/Radio Canada, December 19, 2020. https://www.cbc.ca/news/canada/edmonton/900-albertans-opioid-poisoning-1.5846860.


[3] “Alberta Opioid Response Surveillance Report: First Nations People in Alberta.” Alberta First Nations Governance Centre. Accessed October 17, 2021. https://open.alberta.ca/dataset/ef2d3579-499d-4fac-8cc5-

94da088e3b73/resource/1d3c4477-7a5b-40a8-90f0-a802dbfd7748/download/health-alberta-opioid-response-surveillance-report-first-nations-people-2021-06.pdf.


[4] “Alberta Government Sued over New Rules for Supervised Sites for Drug Use | CBC News.” CBCnews. CBC/Radio Canada, August 20, 2021. https://www.cbc.ca/news/canada/edmonton/alberta-supervised-consumption-sites-nanda-lawsuit-1.6147194.


[5] Riebe, Natasha. “Edmonton Mayor Points Finger at Province for Recent Drug Overdoses | CBC News.” CBCnews. CBC/Radio Canada, May 28, 2021. https://www.cbc.ca/news/canada/edmonton/city-overdoses-iveson-1.6043616.


[7] Smockum, Dayna. “Alberta Government Announces New Regulations for Safe Consumption Sites.” Calgary. CTV News, June 2, 2021. https://calgary.ctvnews.ca/alberta-government-announces-new-regulations-for-safe-consumption-sites-1.5453954.


[8] Labby, Bryan. “Unsanctioned Injection Site Opens in Lethbridge, Home to Highest Rate of Opioid Overdose Deaths in Alberta | CBC News.” CBCnews. CBC/Radio Canada, October 2, 2020.https://www.cbc.ca/news/canada/calgary/lethbridge-supervised-injection-site-unsanctioned-1.5737627.


[9] Mertz, Emily. “Ems Responded to 55 Opioid-Related Calls in Edmonton in 2-Day Period: AHS - Edmonton.” Global News. Global News, June 4, 2021. https://globalnews.ca/news/7918803/ems-opioid-calls-edmonton-drug-use-overdose-alberta/.


[10] Gunter, Lorne. “Gunter: Report Reveals Real Problems Safe Injection Sites Create in Alberta Cities.” edmontonsun. Edmonton Sun, March 6, 2020. https://edmontonsun.com/opinion/columnists/gunter-report-reveals-real-problems-safe-injection-sites-create-in-alberta-cities.